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Complaint Form

Contact Information

Use this property to display a short description or any instructions, notes, or guidelines that the visitor should read when filling out the form. This will appear directly below the form name.

Last Name

First Name and Initial

Address

City

Province

Postal Code

Phone (Home)

Phone (Work)

Email

Date Reported

Time Reported

Time Period
A.M.
P.M.
Was anyone Involved in the Complaint Less than 18 years old at the Time of the Incident:
Yes
No
If Yes, Give Name:

Details of Complaint

Date

Time

Time Period
A.M.
P.M.
LocationPolice Service

Specific Allegations of Misconduct

Misconduct 1Misconduct 2Misconduct 3Misconduct 4Summary of Incident

Details of Injuries Sustained from Complaint Incident

Attending Physician

Address

Telephone

Date Attended

Hospital Attended

Attending Physician

Telephone

Date Attended

Witness 1

Witness NameAddress

Phone

Witness 2

Witness NameAddress

Phone

Witness 3

Witness NameAddress

Phone

Note: An intentionally false complaint under The Police Act, 1990 may result in criminal charges for public mischief or obstructing a Peace Officer.

You will receive a written report at the conclusion of the investigation into your complaint. Where the investigation is not completed within 60 days, you will receive an interim report on the status of your complaint with a further report every 60 days until the matter is concluded.

Where a complaint results in a discipline hearing being ordered, you will be advised of the time, date and place of the hearing. You have the right to attend that hearing and to be represented by counsel.